This list was compiled by myself and my counterpart, Heeler, RN. She is a much more experienced nurse who is a wealth of nursey knowledge.
1. Forget to flip the feeding tube stop cock and spray yourself, your patient, and your freshly changed bed with tube feeding residuals.
Don’t forget to flip your stopcock before flushing anything! And if you don’t have a stopcock on there, go grab one! They’re called Lopez valves, usually. They’re pretty helpful.
2. Save all of your charting until the end of the shift. Good luck clocking out never because now you remember nothing.
Don’t do it! You won’t remember anything; even those things you consciously tell yourself to remember Chart as you go, young grasshopper.
3. Not checking with the other nurses before calling a doctor and then interrupt them during surgery to tell them something that doesn’t matter/could wait until next rounds.
If you’re going to call for something, just double check with someone else until you get the hang of it. I know in school you’re supposed notify the MD immediately for literally everything. However, there are a lot of things that can wait for them to round. Even if they’ve already rounded for the day and you think you need to call, just check. It may be something that can wait for the next day or something your unit has a protocol/standing order for already.
Hint: if they have a midlevel provider, always call them first! (Nurse Practitioner or Physician’s Assistant)
4. Trusting your confused patient when she says she won’t pull her IV + NG + foley out if you just take her restraints off for a few minutes.
Never, ever trust confused patients. All your IV’s will be out, their foley will be across the room, and gastric contents are all over the fresh bed you just made. And now you have to clean everything up and reinsert everything. Some can be very convincing – don’t do it!
5. Overfill your scrub pockets with alcohol wipes, scissors, Vasaline, KY jelly, portable pulse ox, gum, pens, tape, gauze, and highlighters. (You’ll never find what you need when you need it.)
When a doctor comes by and starts spouting off 12 different orders as he’s quickly walking past you to an emergency.. you need to get to that pen fast! Don’t dilute your pockets with crap you don’t need. Grab a handful of alcohol swabs for a pocket, 1 pen, 1 Sharpie, a penlight, a pair of scissors, and one roll of tape. You don’t need anything else in your pockets all day. If you have other stuff, just keep it at the RN station.
6. Taking 45 minutes to get report because you write down all the things that don’t matter. And you write everything out.
Figure out shorthand/abbreviations and don’t make the off-going nurse go through 20 minutes of information you can easily get off the chart.
#1 – what’s wrong with them #2 – pertinent history #3 – what do I need to do today? #4 – what do I need to clarify with the physician? #5 – what the plan of care? Generally speaking, you can get the rest of the information from the chart.
Don’t freak out and act like they’re incompetent if they forgot to tell you about something like a basic wet-to-dry dressing or something.
7. Thinking you’ll get a light assignment because, hey, it’s your first day out of orientation.
Hopefully they’ll be gentle, but it may not happen! You may be surprised with the responsibility you’re given that first shift. You’ll make it! Take a look at my post called “OMG I’M OFF ORIENTATION” under the New Grads tab for some more hints.
8. Thinking all of your meds will be given at the exact time they’re due.
You’re not efficient yet. You will be, eventually. You’ll be passing meds, charting assessments, calling docs, and doing dressing changes all at the same time. But it’ll take time to get there. Don’t get down on yourself if you’re having a rough time getting those meds to all of your patients on time.
9. Assuming your patient who has been a diabetic for 20+ years that they’ll tell you before they eat so you can check their blood sugar since they’re on sliding scale and 20 units of scheduled insulin.
I have been burned by this. One would think they’d let you know they’re getting ready to eat, but that doesn’t always happen. Then you have to call the doctor to see what they want to do because you can’t take their sugar now, it’ll be high and you can’t treat it with sliding scale because it’d be for an inaccurate blood sugar… and you have no idea if they were really low before they ate so you don’t want to bottom them out with their 20 units. Something I started doing with anyone who has AC/HS (before meals + at bedtime) blood sugar checks, is when I’m introducing myself in the morning, I say, “now I want you to put your call light on and wait for us to take your sugar if you meal gets here before we take it; it effects your insulin!” Alas, even that doesn’t work.
10. Thinking night shift is easier because all of your patients are asleep.
Ha! Yea. Right. Sundowners galore. Plus no one is there; you have to know your resources. You always have to call the on-call doctors who may not know anything about your patient. Night shift is equally as difficult, just in its own special way
10.5 Getting excited about your paycheck.
After all the blood, sweat, tears, and poop you’ve endured for two weeks.. you’re ready for a big check! Well, after deductions + bills, it quickly dwindles. Better pick up some overtime!